We carried out a review of the data available to us about White Pearl Residential Care on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about White Pearl Residential Care, you can give feedback on this service.
White Pearl Residential Care is a residential care home providing accommodation and personal care to up to 18 people. The service provides support to people with mental health issues including paranoid schizophrenia and substance misuse. At the time of our inspection there were 17 people living at the service.
People’s experience of using this service and what we found
People were safe living at the home. One person said, “I feel really safe. Staff look after you, making a future for you”. Staff had completed training on safeguarding and understood the signs of potential abuse. There were sufficient trained staff on duty to meet people’s needs. People received their medicines as prescribed.
People were supported with a healthy lifestyle and with a healthy diet. Some people enjoyed preparing their lunchtime meal. One person said, “The food is great here; I love the food”. People had access to a range of health and social care professionals. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.
People were looked after and supported by kind, caring staff who knew them well. The atmosphere in the home was calm and relaxed. People were encouraged to be as independent as possible. They were treated with respect and dignity.
People were involved in all aspects of their care, including decision making and their aspirations for the future. Complaints were dealt with informally and people told us they had never had to make a complaint.
People spoke highly of the way the home was managed. One person said, “The management is good. The owner is a nice person and the lady looking after us is clever and has good ideas. This place is just naturally good, sociable”. A system of audits was used to monitor and measure the service overall and to drive improvement. People’s feedback was obtained and all was positive in the records we reviewed.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection and update
The last rating for this service was requires improvement (published 1 February 2021) and there were breaches of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.
Why we inspected
We undertook this targeted inspection to check whether the Warning Notice we previously served in relation to Regulation 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 had been met. The provider did not have robust systems in place to monitor the service and drive improvement.
We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.
The overall rating for the service has changed from requires improvement to good based on the findings of this inspection.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for White Pearl Residential Care on our website at www.cqc.org.uk.
Enforcement
At the last inspection we recognised that the provider had failed to notify CQC of all incidents of abuse or allegation of abuse in relation to people. This was a breach of Regulation 18 of the Care Quality Commission (Registration) Regulations and we issued a Fixed Penalty Notice. The provider accepted a fixed penalty and paid this in full.
Follow up
We will continue to monitor information we receive about the service, which will help inform when we next inspect.
White Pearl is a residential care home providing personal care and accommodation to people with mental health needs including paranoid schizophrenia, bi-polar disorder and substance misuse. Some people also have health needs such as diabetes and epilepsy. There were 16 people receiving a service at the time of inspection.
The service is located in Worthing and can accommodate up to 18 people in one adapted building. People are supported with drug and alcohol addictions and with making healthy lifestyle choices. The purpose of the service is to provide people with a safe place to live and support to prevent homelessness.
People’s experience of using this service and what we found
People lived independent lifestyles and the service provided a safe place for people to live. A person told us "It feels safe living here. I have a key to my room".
However, the location had not always notified CQC of potential allegations of abuse which meant people could not be assured that systems at the home promoted their safety. Risk assessments did not provide sufficient information or guidance to staff to mitigate identified risks. Some aspects of medicines were not managed safely. Specific safety advice about medicines was not always being monitored effectively and exposed people to potential risk of harm. There were not always adequate measures in place to prevent infection in the home. We have signposted the provider to Public Health England guidance, ‘COVID-19: how to work safely in care homes’.
The service benefited from a consistent staff team and we observed staff working in a person-centred manner.
At the last inspection we identified that the provider had not always ensured staff had adequate training to meet the specific needs of people. At this inspection, the provider had ensured staff had completed mandatory training however, the majority of staff had not completed specific training around mental health or substance misuse. This increased the potential risk of staff lacking the skills to support people effectively when required.
People were happy with the care they received and felt safe with the staff that were supporting them. Health professionals told us they have regular staff so are able to provide continuity and have good working relationships that are recovery focused.
People told us about how the home had encouraged healthy eating choices that had resulted in positive weight loss for several people. . The kitchen was not currently accessed by people. This was as an infection reduction measure during the pandemic, however had limited peoples access to snacks when they chose. People were supported to be involved in improvements to the environment. One person told us about work they had completed in the garden during lockdown resulting in the home having a new water feature and greenhouse. The provider and staff recognised where people were subject to Community Treatment Orders (CTO) and demonstrated knowledge of any conditions that applied to those.
The providers Statement of Purpose set out the vison for the service, “All service users will have an opportunity to recover and re-engage with the local community as part of their recovery pathway from contact with statutory services to greater social inclusion and independence in the community”. This vision was not always evident from the information reviewed. The registered manager had recognised that this was not always being achieved at the moment. The provider had regular audits in place these did not always identify risks or actions.
People's privacy and dignity was respected, and people's diverse needs were supported. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
The last rating for this service was requires improvement (published 27 November 2019) and there were multiple breaches of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection insufficient improvements had been made, and the provider remained in breach of regulations. The service remains rated requires improvement. This service has been rated requires improvement for the last three consecutive inspections.
Why we inspected
This was a planned focused inspection based on the previous rating and concerns received over the past six months during the pandemic.
We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to coronavirus and other infection outbreaks effectively.
We have found evidence that the provider needs to make improvements. Please see the Safe, Effective and Well-led sections of this full report.
You can see what action we have asked the provider to take at the end of this full report.
We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection. The overall rating for the service has remained requires improvement. This is based on the findings at this inspection.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for White Pearl Residential Care on our website at www.cqc.org.uk.
Enforcement
We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to discharge our regulatory enforcement functions to keep people safe and to hold providers to account where it is necessary for us to do so.
We have identified two continued breaches of regulation. Quality assurance processes were not in place to assess, monitor and improve the quality and safety of the service. CQC had not been notified of reportable events. There was one new breach of regulations. Medication was not always being safely or properly managed You can see what action we have asked the provider to take at the end of this full report
Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.
Follow up
We will meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. We are considering what further enforcement action to take.
White Pearl is a residential care home providing personal care and accommodation to people with mental health needs including paranoid schizophrenia, bi-polar and substance misuse. Some people also had health needs such as diabetes and epilepsy. There were 16 people receiving a service at the time of inspection.
The service is located in Worthing and can accommodate up to 18 people in one adapted building. People are supported with drug and alcohol addictions and with making healthy lifestyle choices. The service provides people with a safe place to live and provides support to prevent homelessness.
People’s experience of using this service and what we found
People lived independent lifestyles and the service provided a safe place for people to live. People said they received good support and safe environmental experiences. Records and administration procedures were not in place to underpin practice or people’s experiences and to ensure they were provided with consistent care.Health and social care risk assessments lacked important detail to guide staff on how to make people safe. Support plans did not contain detailed and person-centred information and therefore these did not always accurately reflect the needs of those who used the service. We have made a recommendation about reviewing and updating care plans.
There was not an adequate process for assessing and monitoring the quality of the services provided and ensuring that records were accurate and complete. The provider's arrangements for ensuring staff were appropriately trained were not sufficiently robust. CQC were not always notified of events which the provider is required to notify us of by law.
People were happy with the care they received and felt safe with the staff that were supporting them. There were sufficient numbers of staff to ensure people received support when they needed it. People had direct access to staff at all times.
People spoke positively about the staff and supportive and caring relationships had been developed between staff and people. People were treated with kindness and compassion and staff were friendly and respectful. People benefited from having support from a consistent staff team.
People's privacy and dignity was respected, and people's diverse needs were supported. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection and update
The last rating for this service was requires improvement (published 16 November 2018) and there were two breaches of regulation. The provider failed to complete an action plan after the last inspection to show what they would do and by when to improve. At this inspection not, enough improvements had been made and the provider was still in breach of regulations. This service has been rated requires improvement for the last two consecutive inspections.
Why we inspected
This was a planned inspection based on the previous rating.
Enforcement
We have identified one continued breach of regulation. Quality assurance processes were not in place to assess, monitor and improve the quality and safety of the service. There were three new breaches of regulations. This was because records were not up to date to ensure risks were identified and people were safe and supported by a skilled staff team. CQC had not been notified of reportable events. You can see what action we have asked the provider to take at the end of this full report.
Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.
Follow up
We will request an action plan for the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.
White Pearl Residential Care is registered to provide accommodation and residential care for up to 18 people with a variety of mental health needs, including conditions such as paranoid schizophrenia, bi-polar disorder and substance misuse. At the time of the inspection, 14 people were living at the home. Communal areas include a large sitting room with dining area and access to extensive rear gardens. There is also a quiet lounge and a designated smoking area. All rooms are of single occupancy and have en-suite facilities. A lift is available for people if required. White Pearl Residential Care is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided and both were looked at during this inspection.
A registered manager was in post. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.
Some aspects of medicines were not managed safely. Gaps in the completion of some Medication Administration Records (MAR) meant that one person may not have received their medicines on two occasions as prescribed. MAR had not always been completed accurately by staff or in line with National Institute for Clinical Excellence (NICE) guidelines. The recording of one medicine had not been done as legally required. Medicines were not audited to check that medicine administration worked effectively and any issues could be identified and addressed.
Staff said they completed training in safeguarding adults at risk, but some staff did not have a full understanding of the subject or how to keep people safe. We have made a recommendation about safeguarding training for staff. Staff had completed training in a number of areas, but there was no formal training plan to confirm that staff had completed the training they required. Staff were encouraged to study for vocational qualifications in health and social care.
Systems or processes had not been established to assess or monitor the service provided to people. Risk assessments were lacking in some areas, but there was no evidence to show this impacted on people's safety. Auditing systems had not been set up to monitor or measure the quality of care or to drive improvement. People’s feedback about the service had not been requested or documented formally.
There were sufficient numbers of staff on duty to meet people’s needs. Checks were made on new staff to ensure they were of good character and safe to work with people.
People were supported to have sufficient to eat and drink and had a choice of menu. They had access to a range of healthcare professionals and services. People’s rooms were personalised and they had access to outdoor space. The registered manager worked with a variety of organisations to deliver effective care. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.
People were looked after by kind and caring staff who knew them well. Staff respected people’s privacy and supported them to be as independent as possible. People were encouraged to be involved in all aspects of their care.
Information within care plans was not detailed, but staff knew people well and how to support them. The deputy manager had plans to improve records in relation to care plans, risk assessments and to set up auditing systems. People pursued their own interests in the community and were free to go out during the day.
Formal supervision meetings did not occur, but the registered manager worked alongside staff and observed their working practice. Staff felt supported by the managers and enjoyed working at the service. The registered manager had a clear vision about the service and how to support people to recover and move back into the community. People said staff were always available and had time to spend with them.
Due to the shortfalls we found in the monitoring of the quality of the service and in the management of medicines we found two breaches of regulations. You can see what action we told the provider to take at the back of the full version of the report.